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Project Twenty1 21-Day Filmmaking Competition Certification Form (2012) Team Name: ______________________________________

Film Name: ______________________________________

I _________________________ certify that I am the Leader of the Team listed above, a Team participating in Project Twenty1’s 2012 21-Day Filmmaking Competition. I also certify that all creative work on the above film (including all screenwriting, shooting, original scoring, and editing) occurred between the Project Twenty1 Launch Event and the Drop Event. I also certify that I have obtained all legal rights, waivers, releases and signatures required for all cast, crew, locations, music, and all other types of materials appearing in our film and related promotional materials and behind-the-scenes footage being submitted to Project Twenty1, and that I am legally permitted to submit all elements of the film listed above without infringing on the rights of any parties involved in its creation. I certify that I will be able to produce these documents for Project Twenty1 on demand if necessary at any point in the future. I also understand that if I am unable to produce these documents on demand, the film may be pulled from any promotion, screening, or marketing efforts in which Project Twenty1 is currently engaged. I hereby certify that the Film Listed above is being submitted as an “Official 21-Day Filmmaking Competition Film” for the Date listed, and is thus eligible for all Awards and Prizes that Project Twenty1 judges might administer to it. I hereby also certify that our Team agrees to abide by all rules set forth in the Official 21-Day Filmmaking Competition Participant’s Agreement.

Signature: ____________________________________

Printed Name: _________________________________

Date: ________________________________________


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